Abstract
The often poorly orientated small-bowel mucosal biopsies taken for the diagnostics of celiac disease and other intestinal disorders are prone to misinterpretation. Furthermore, conventional histopathology has suboptimal sensitivity for early histopathological changes observed in short-term challenge studies. X-ray microtomography (micro-CT) is a promising new method for accurate imaging of human-derived biological samples. Here, we report that micro-CT could be utilized to create virtual reconstructions of endoscopically obtained intestinal biopsies. The formed digital 3D images enabled selection of always optimal cutting angles for accurate measurement of the mucosal damage and revealed diagnostic lesions in cases interpreted as normal with conventional histomorphometry. We also demonstrate that computer-assisted point cloud analysis can be used to calculate biologically meaningful surface areas of the biopsies in different stages of mucosal damage with excellent replicability and correlation with other disease parameters. We expect the improved diagnostic accuracy and capability to measure the surface areas to provide a powerful tool for the diagnostics of intestinal diseases and for future clinical and pharmaceutical trials.
Highlights
The often poorly orientated small-bowel mucosal biopsies taken for the diagnostics of celiac disease and other intestinal disorders are prone to misinterpretation
There is a preference for a less invasive diagnostic approach, at least in Europe, but the biopsy remains obligatory in adults and in children with low positive celiac serology, i.e. in the diagnostically most challenging c ases[5,6]
We investigated whether micro-CT imaging could be utilized to improve the accuracy of the morphometric analyses of small-bowel mucosal biopsies and with distinguishing between healthy and diseased states, in subjects with suspected celiac disease
Summary
The often poorly orientated small-bowel mucosal biopsies taken for the diagnostics of celiac disease and other intestinal disorders are prone to misinterpretation. The formed digital 3D images enabled selection of always optimal cutting angles for accurate measurement of the mucosal damage and revealed diagnostic lesions in cases interpreted as normal with conventional histomorphometry. The diagnosis has traditionally been based on the histopathologic evaluation of small-bowel mucosal biopsies Since this is conducted on cross-sectional cuttings of the original 3D sample, precise orientation of the specimen is critical, but often difficult (Supplementary Fig. 1). We investigated whether micro-CT imaging could be utilized to improve the accuracy of the morphometric analyses of small-bowel mucosal biopsies and with distinguishing between healthy and diseased states, in subjects with suspected celiac disease. As a completely novel approach to attain precise information of the mucosal changes, we explored the possibility of performing surface area measurements from the digitalized biopsies
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
